It is challenging for clinicians to carry out successful periodontal therapy and maintain a full dentition in young patients with generalized bone loss of 90%. Due to advanced attachment loss and the young age of patients, fixed or removable prosthetic treatment options are compromised. Implant therapy would be complex and expensive. The presented case shows the successful conservative periodontal therapy of advanced generalized aggressive periodontitis in a 29-year-old female. A conservative approach was applied and maintained all teeth with patient satisfaction both functionally and esthetically. This case was followed over 5 years.